Senior Manager, Provider Engagement, DentaQuest - South Carolina

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.  

DentaQuest manages dental and vision benefits for more than 33 million Americans. Our outcomes-based, cost-effective solutions are designed for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals. With a focus on prevention and value, we aim to make quality care accessible to improve the oral health of all.

Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work in the contiguous states plus AK.

Candidates must reside in the state of South Carolina.

The opportunity:

The Senior Provider Network Manager provides guidance and oversight to Provider Partners regarding benefit programs, policies, and procedures. The position handles identifying and addressing network gaps, recognizing and implementing process improvement opportunities, and monitoring CAP performance. This position mentors and coaches their team in provider recruitment and engagement. In addition to managing staff, the role may also have responsibility for covering larger or more complex situations and markets.

How you will contribute:

• Manage and Guide provider engagement staff

• Ensure provider engagement staff recruits providers within cost and access goals

• Authorize and negotiate special deals

• Develop strategic action plan to address network gaps

• Develop provider education curriculum and approach

• Cover more markets or highly complex markets

• Organize amendment and recruitment projects

• Develop project plans, internal/external reports, and ensure deliverables are met

• Identify and coordinate implementation of quality/cost improvements

• Manage reporting process to identify and modify provider outliers

• Provide cross-market aid as needed

• Analyze and monitor provider performance reports

• Participate in and often present during client, organized dentistry and key stakeholder meetings/events

• Identify continuous improvement opportunities

• Manage CAP office performance

• Coordinate and implement appropriate performance management strategies for team members to include:

• Assist in the hiring process, including interviewing candidates.

• Assist, train and motivate team members.

• Evaluate and measure effectiveness of team members.

• Assist in preparation of performance and wage evaluations in accordance with company policy.

• Manages attendance and company-approved time off for team members.

• Participate in the drive and implementation of Performance Improvement Plans and performance management initiatives.

• Other duties as assigned

What you will bring with you:

• Bachelor’s degree in Business, Healthcare Administration (or related field) or equivalent, relevant experience.

• 5 years of experience in healthcare practice or managed care environment.

• 5 years’ supervisory/management experience preferred

• Experience in a managed care environment preferred

• Excellent verbal and written communication skills.

• Ability to work alone and as part of a team.

• Knowledge of Microsoft Office.

• Proven problem-solving skills.

• Problem-solving and training experience.

• Ability to make sound judgment conclusions based on data available with minimal oversight.

• Up to 20% of travel as needed.

Salary:

Salary Range: $78,100 - $117,200

At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your uniq